Patients Come Out On Top In 2 Of Every 3 Suits

April 14, 1986|By Alex Beasley and Rosemary Goudreau of the Sentinel staff

In Orange County, medical malpractice usually means a mishandled childbirth, an undiagnosed illness, a doctor slow to answer his pages or a patient complaint that goes unheeded.

Malpractice that leads to litigation often has caused or contributed to a death, and people who sue for malpractice in the county win cash settlements or awards in more than two of every three cases.

The frivolous suit, pegged by the medical profession as the bad boy behind Florida's malpractice crisis, is the exception rather than the rule.

Even settlements of a few thousand dollars, generally written off by doctors as expedient quashing of ''nuisance suits,'' can involve a

minor but significant injury directly related to negligence.

Doctors contend that if decisions to settle were in their hands rather than in the hands of their insurance companies, they would fare much better.

Those were among the major findings of an Orlando Sentinel review of every medical malpractice suit filed in Orange County during a five-year period from 1980 to 1984. The study, which was analyzed by computer, involved 325 cases, 315 physicians, 21 other health practitioners and every hospital in the county.

The Sentinel's research is the first of its kind in Florida.

The study found that, for the most part, patients took their doctors to court for failing to practice basic medicine, overprescribing drugs, ignoring distress signals of expectant mothers or botching surgery.

Hospitals usually found themselves in court on claims of inadequate or untrained staff, falls, failing to monitor a patient, unsterile conditions or for injections that damaged nerves and left limbs paralyzed.

Orlando attorney Nolan Carter, who estimates he has handled 300 malpractice cases for patients since he began practicing law in 1967, believes ''people are less willing to accept medical mistakes than they were in the past. Because doctors are so highly trained, the public expects a great deal from them.''

Medical leaders caution that a malpractice suit against a doctor or a hospital does not necessarily mean that the physician practices bad medicine or the hospital provides low-quality care.

''There are doctors who are incompetent and who make mistakes . . . but my experience has been that the vast number of doctors are very competent and doing a good job,'' said Donald Smith, an Orlando lawyer who has been practicing nearly 30 years, most of that time representing doctors.

Among the newspaper's major findings:

-- Patients or their families received settlements or awards in nearly 69 percent of the 240 Orange County cases that had been resolved. Patients fared better in getting out-of-court settlements than in winning jury trials. Doctors and hospitals won 14 of the 23 cases that went to trial. Eighty-five of the suits filed during the five-year period were not settled at the end of the study.

The number of settlements was learned from court documents, Florida Department of Insurance records and responses to nearly 100 letters sent to lawyers for patients and defendants.

According to Dr. Richard Bagby, Orange County Medical Society president, the decision to settle a case early most often is made by the doctors' insurance companies, which want to avoid the high cost of going to trial. He speculated that if more cases were taken to trial, doctors probably would fare better.

-- Childbirth led to more lawsuits than any other medical procedure, accounting for 42 of the 325 suits. The treatment of cancer and emergency-room patients led to the second-highest number of suits, 32 each.

Most emergency-room patients who sued complained that the treatment they received was substandard, but the majority of cancer victims claimed their disease was misdiagnosed or undetected. Nine of those victims died.

-- The claims linked 53 deaths directly to poor medical care. All but 10 of the resulting suits have been resolved, with the families receiving a cash settlement in 74 percent of them.

In most of the cases, families claimed that the deaths were caused by poor treatment or delays in treatment such as failing to respond to emergencies or requests for aid.

Example: In 1982, Edgar Coble of Altamonte Springs was hit by a car. Conflicting orders after surgery for massive injuries sent Coble to the hospital's general ward instead of to a special-care unit where he could have been more closely monitored. When Coble suffered complications the next day, his doctor could not be reached, and Coble went unattended for several hours. He died the next day.

Coble's widow sued the hospital and six doctors who treated her husband. She won an out-of-court settlement for more than $500,000.

-- The amount of money paid out in Orange County lawsuits was substantial. Of the 164 cases in which there were settlements or jury awards, exact figures could be obtained for 91. In those cases patients received a total of $14.4 million.